The second to last stage of Alzheimer’s consists of the move to the frontal lobe. This is when the loss of ability to interact socially is activated, as well as loss of reasoning and judgment. It is in this time that we see patients sometimes exhibit violent tendencies, and extreme mood swings. During this phase the subject loses their social skills entirely prompting some problematic behavior
(Callone): “Persons with
Alzheimer’s may exhibit behaviors that are considered inappropriate, such as
exposing their genitals in public. Some persons will undress completely and
wander into public spaces oblivious to their behavior. Urination in public
places may also occur. Some persons with SDAT will make frequent demands for
sexual intercourse or will propose sexual intercourse in the company of
visitors” (Long 214).
On an anecdotal note, I myself have been witness to this behavior, and it can be rather disturbing for the outside parties involved. But I think what was the most upsetting is when, or if, the subject becomes lucid momentarily long enough to recognize what had just taken place. Sometimes in this case, the subject will become ashamed of their actions and react in a violent outburst. Unfortunately, my Uncle had dementia and I can remember the instances when he would be lucid just long enough to recognize that he had done something inappropriate. The usual reaction would be some version of self-destructive behavior, because he was unable to communicate he became frustrated and acted out.
It was when my Uncle had jumped from his reality into ours where the problems in disassociation became real for him. Without the ability to communicate, or to have full control of motor functions, the shift into our world again was emotionally devastating. It is around this phase where, if the patient were receiving in home care, they may be more likely to move into a facility where they can have round the clock care. And it is also at this time where a significant switch might occur in the attitude of the patients loved ones.